Surgical suturing instrument and method of use

Abstract

A device is disclosed for introducing a flexible elongated element through at least two portions of a subject. In an embodiment, the device includes a proximal end and a distal end, as well as an advancement unit for longitudinally advancing the flexible elongated element toward the distal end such that a proximal end of the elongated element may pass from the distal end of said device with sufficient force to pass through the portions of the subject. The device also includes a securing unit for variably adjusting a securing force applied by the flexible elongated element to secure together the portions of the subject.

What is claimed is:  
     
       1. A tool for joining a first layer of material to a second layer of material, said tool comprising: 
       a handle;  
       an end effector mounted on said handle and defining therein:  
       a first channel for retaining a wire guide;  
       a second channel extending from the first channel for supporting a suture wire extending from the wire guide;  
       a passageway for retaining a cutter bar; and  
       an end recess;  
       said second channel being curved to impart a looping configuration to portions of the suture wire passed therethrough; and  
       said end recess having a curved surface at a bottom of said end recess, such that the end recess is adapted to receive the looped suture wire emerged from said second channel;  
       a wire advancing actuator mounted on said handle for moving the suture wire through said second channel and through the material first and second layers; and  
       a wire cutting actuator mounted on said handle for moving the cutting bar into cutting engagement with the suture wire.  
     
     
       2. The tool in accordance with  claim 1  wherein said end effector is provided with a planar distal end. 
     
     
       3. The tool in accordance with  claim 1  wherein said cutting bar includes a flexible blade portion, and said end effector is provided with a blade channel in which the flexible blade is disposed and which intersects said second channel. 
     
     
       4. The tool in accordance with  claim 1  wherein said end effector is pivotably mounted relative to at least a portion of said handle. 
     
     
       5. The tool in accordance with  claim 1  wherein said wire cutting actuator is adapted to move the cutting bar axially into the cutting engagement with the suture wire. 
     
     
       6. The tool in accordance with  claim 1  wherein said wire cutting actuator is adapted to move the cutting bar rotatively around a central axis thereof into the cutting engagement with the suture wire. 
     
     
       7. The tool in accordance with  claim 2  wherein said end recess is provided with a funnel-like side surface defining an opening in the planar distal end for receiving the looped suture wire and directing the received suture wire toward the recess curved bottom surface. 
     
     
       8. The tool in accordance with  claim 5  wherein said end effector is provided with a planar distal end having a recessed cut-out therein, such that pressing of the distal end against a soft material layer causes bulging of the material layer into the cut-out, to permit deep penetration of the suture wire. 
     
     
       9. The tool in accordance with  claim 5  wherein a distal end of the cutting bar is of a concave configuration. 
     
     
       10. The tool in accordance with  claim 1  wherein said end effector further comprises a tip forming die proximate a distal portion of said second channel, said die and the cutting bar being engageable with each other, after the cutting bar effects a cutting operation, to bend a cut end of the suture wire inwardly of a formed loop of the suture wire. 
     
     
       11. The tool in accordance with  claim 1  wherein the first and second layers of material comprise first and second layers of tissue. 
     
     
       12. The tool in accordance with  claim 1  wherein the first layer of material comprises a prosthesis and the second layer of material comprises a layer of tissue. 
     
     
       13. The tool in accordance with  claim 12  wherein the prosthesis comprises a surgical mesh and the layer of tissue comprises an abdominal wall. 
     
     
       14. A tool for joining a first layer of material to a second layer of material, said tool comprising: 
       a handle;  
       an end effector mounted on said handle and comprising:  
       a first fixed portion defining therein a first groove defining a portion of a first channel for retaining a wire guide;  
       a second channel extending from the first channel for supporting a suture wire extending from the wire guide;  
       a portion of a passageway for retaining a cutting bar; and  
       wall structure defining a portion of an end recess in a distal end of said end effector; and  
       a second fixed portion defining therein a first groove defining a remainder of the first channel;  
       a second groove defining a remainder of said passageway;  
       a wall portion defining a remainder of said second channel; and  
       a sidewall for defining a remainder of the end recess;  
       said second channel being curved to impart a looping configuration to portions of the suture wire passed therethrough;  
       the end recess being defined in part by a curved surface in said end effector defining a bottom of the end recess, such that the end recess is adapted to receive the looped suture wire emerged from said second channel;  
       a wire advancing actuator mounted on said handle for moving the suture wire through said second channel and through the material first and second layers; and  
       a wire cutting actuator mounted on said handle for moving the cutting bar into cutting engagement with the suture wire.  
     
     
       15. The tool in accordance with  claim 14  wherein said first and second fixed portions are provided with first and second planar distal ends, respectively, and the first and second planar distal ends are in the same plane. 
     
     
       16. The tool in accordance with  claim 14  wherein said cutting bar includes a flexible blade portion and said first fixed portion is provided with a blade channel in which the flexible blade is disposed and which intersects with second channel. 
     
     
       17. The tool in accordance with  claim 14  wherein said end effector is pivotally mounted relative to at least a portion of said handle. 
     
     
       18. The tool in accordance with  claim 14  wherein said wire cutting actuator is adapted to move the cutting bar axially into the cutting engagement with the suture wire. 
     
     
       19. The tool in accordance with  claim 14  wherein said wire cutting actuator is adapted to move the cutting bar rotatively around a central axis thereof into the cutting engagement with the suture wire. 
     
     
       20. The tool in accordance with  claim 15  wherein said end recess is provided with a funnel-like side surface defining an opening in the planar distal end for receiving the looped suture wire and directing the received suture wire toward the recess curved bottom surface. 
     
     
       21. The tool in accordance with  claim 18  wherein said end effector is provided with a planar distal end having a recessed cut-out therein, such that pressing of the distal end against a soft material layer causes bulging of the material layer into the cut-out, to permit deep penetration of the suture wire. 
     
     
       22. The tool in accordance with  claim 18  wherein a distal end of the cutting bar is of a concave configuration. 
     
     
       23. The tool in accordance with  claim 14  wherein said first fixed portion further comprises a tip forming die proximate a distal portion of said second channel, said die and the cutter bar being engageable with each other, after the cutting bar effects a cutting operation, to bend a cut end of the suture wire inwardly of a formed loop of the suture wire. 
     
     
       24. The tool in accordance with  claim 14  wherein the first and second layers of material comprise first and second layers of tissue. 
     
     
       25. The tool in accordance with  claim 14  wherein the first layer of material comprises a prosthesis and the second layer of material comprises a layer of tissue. 
     
     
       26. The tool in accordance with  claim 25  wherein the prosthesis comprises a surgical mesh and the layer of tissue comprises an abdominal wall.